The association of plasma lactate with incident cardiovascular outcomes: the ARIC Study
Autor: | Kunihiro, Matsushita, Emma K, Williams, Morgana L, Mongraw-Chaffin, Josef, Coresh, Maria Ines, Schmidt, Frederick L, Brancati, Ron C, Hoogeveen, Christie M, Ballantyne, J Hunter, Young |
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Rok vydání: | 2013 |
Předmět: |
Heart Failure
Male Community-Based Participatory Research Alcohol Drinking Incidence Original Contributions Smoking Coronary Disease Comorbidity Middle Aged United States Stroke Survival Rate Diabetes Mellitus Humans Female Lactic Acid Obesity Biomarkers Follow-Up Studies Proportional Hazards Models |
Zdroj: | American journal of epidemiology. 178(3) |
ISSN: | 1476-6256 |
Popis: | We examined the association of plasma lactate at rest, a marker of oxidative capacity, with incident cardiovascular outcomes in 10,006 participants in the Atherosclerosis Risk in Communities (ARIC) Study visit 4 (1996–1998). We used Cox proportional-hazards models to estimate hazard ratios of incident coronary heart disease, stroke, heart failure, and all-cause mortality by quartiles of plasma lactate (Q1, ≤5.3 mg/dL; Q2, 5.4–6.6; Q3, 6.7–8.6; and Q4 ≥8.7). During a median follow-up time of 10.7 years, there were 1,105 coronary heart disease cases, 379 stroke cases, 820 heart failure cases, and 1,408 deaths. A significant graded relation between lactate level and cardiovascular events was observed in the demographically adjusted model (all P for trend < 0.001). After further adjustment for traditional and other potential confounders, the association remained significant for heart failure (Q4 vs. Q1: hazard ratio (HR) = 1.35, 95% confidence interval (CI): 1.07, 1.71) and all-cause mortality (HR = 1.27, 95% CI: 1.07, 1.51) (P for trend < 0.02 for these outcomes) but not for coronary heart disease (HR = 1.02, 95% CI: 0.84, 1.24) and stroke (HR = 1.26, 95% CI: 0.91, 1.75). The results for heart failure were robust across multiple subgroups, after further adjustment for N-terminal pro–B-type natriuretic peptide and after exclusion of participants with incident heart failure within 3 years. The independent associations of plasma lactate with heart failure and all-cause mortality suggest an important role for low resting oxidative capacity. |
Databáze: | OpenAIRE |
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